Changes in high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels have been linked to residual cardiovascular risk, whereas non-HDL-C levels have been shown to be more predictive of cardiovascular risk than are low-density lipoprotein cholesterol (LDL-C) levels. We aimed to investigate the impact of HDL-C, TG, and non-HDL-C levels on acute coronary syndrome (ACS) risk with on-target LDL-C levels.
In all, 424 Caucasian patients aged over 50 years who had LDL-C levels below 3.4 mmol/l with a first or subsequent ACS event were enrolled in a multicenter, retrospective study. Lipid samples were collected within 4 days after the cardiovascular event. The subjects of the age-matched, gender-balanced control group (n = 443) had LDL-C levels below 3.4 mmol/l and were free of cardiovascular diseases.
Patients with ACS had significantly higher TG and lower HDL-C levels compared with the control patients; however, we did not find any significant difference regarding non-HDL-C levels between the two groups. In regression analysis, the risk of coronary heart disease increased significantly with 1 standard deviation (SD) increase in TG and 1 SD decrease in HDL-C levels.
High TG and low HDL-C levels may contribute to residual cardiovascular risk in patients with well-controlled LDL-C levels; however, non-HDL-C levels at admission did not seem to be predictive for patients with ACS. Detection and treatment of secondary lipid targets such as high TG and low HDL-C levels may be important for the prevention of cardiovascular diseases.
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This research was supported by the European Union and the State of Hungary, co-financed by the European Social Fund in the framework of TÁMOP-4.2.2/B-10/1-2010-0024. We would like to thank Zsolt Karányi for his help in the statistical analyses (Department of Medicine, Faculty of Medicine, University of Debrecen).
Conflict of interest
P. Koncsos, P. Fülöp, I. Juhász, K. Bíró, L. Márk, MDG. Simonyi, and G. Paragh declare that they have no competing interests.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.
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Koncsos, P., Fülöp, P., Juhász, I. et al. Changes in triglyceride, HDL-C, and non-HDL-C levels in patients with acute coronary syndrome. Wien Klin Wochenschr 128, 858–863 (2016). https://doi.org/10.1007/s00508-016-1035-4
- High-density lipoprotein cholesterol
- Non-high-density lipoprotein cholesterol
- Acute coronary syndrome
- Residual cardiovascular risk